Name (print or attach business card) 
       
 ____________________________________________________________________________
 
 Title ____________________________

 Company Name ______________________________________________

 Type of business __________________________________________

 Mailing Address  __________________________________________

                  __________________________________________

 City _____________________ State _______ Zip _______

 Phone (______) _________________  
 
 Fax   (______) _________________                      

 E Mail __________________________________________
 
 Co. Web site __________________________________________
 
 Desired password __________________________________________
 (Password should be between 6 and 8 characters long and 
 may be comprised of the characters a-z and 0-9. Passwords
 are case sensitive ['A' is not the same as 'a'].)

Credit Card Information (Visa and MasterCard accepted)

 Name on card __________________________________________
 
 Card number __________________________________________
  
 Expiration date __________________________________________
 
Make checks payable to "Petrick Outsourcing."
Mail to: 679 Hottel Road, Woodstock, VA 22664

Subscription - 540-459-9632
Advertising Office - 540-459-8390
Editorial Office - 540-459-8390
Publisher - Petrick Outsourcing Unlimited, Inc.
    679 Hottel Road Woodstock, VA 22664
Fax - 540-459-3440